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Where's the Next Viagra?

Oct 5, 2010

The crown jewels of erection drugs—Viagra, Cialis, and Levitra—still reign, but scientists are trying to develop alternatives. About 58 clinical trials involving erectile dysfunction are underway, testing everything from new drugs to infrared radiation. Natan Bar-Chama, M.D., an associate professor of urology at the Mount Sinai school of medicine in New York, says the most promising research involves gene therapy, a patented mix of the antioxidant pycnogenol and the amino acid arginine, and drugs based on the brain chemical melanocortin.

“I don’t think the PDE5s are the end all,” he says.

And there’s always the chance a drug will pop up unexpectedly: Viagra rose from research on a drug to treat angina.

“My guess is that it’ll be another 50 to 100 years before we see another breakthrough like that,” says J. Francois Eid, M.D, a clinical associate professor of urology at Weill Cornell Medical College.

In the meantime, tweaks to the Big Three are being tested. The U.S. Food and Drug Administration recently approved the daily use of low-dose Cialis, not just before sex. And Pfizer's U.S. patent for its Viagra formula, sildenafil citrate, runs out in 2012, after which less-expensive generic brands could enter the market.

Click Here for a Urologist While your regular doctor will handle the routine checkups and tests for your privates, he’ll refer you to a urologist if any trouble arises. But how do pick the best specialist? Simply surf your way to a top doc using our two-step guide.

Step 1: Locate a board-certified urologist in your area. You want your prospective doc to be certified by the American Board of Urology (ABU). This certification isn’t required to practice, but it designates that a physician has demonstrated exceptional expertise through both rigorous testing and peer evaluation. For a database of ABU-certified doctors that’s searchable by zip code, or by such specialties as cancer, fertility, or erectile dysfunction, go to the American Urological Association’s Web site at urologyhealth.org.

The male birth control pill has been 5 years away—for the past 25 years. So where does it stand today? “It’s about 5 years away,” says Stephanie Page, M.D., Ph.D., who studies male contraception at the University of Washington Medical Center in Seattle.

There are two major sticking points: First, even though 70 percent of men would use a pill and 25 percent would prefer it to a condom, drug manufacturers aren’t positive the pill would pop with profits. “There’s a perception in the pharmaceutical industry that we already have a birth control solution—it’s the female pill,” says Dr. Page. Second, the success rate in clinical trials has hovered around 95-97 percent—versus 99 percent for the female pill. The male pill would have to at least equal its female counterpart for drug companies to fund its production, says Dr. Page.

Researchers are trying to discover why certain men do not respond to the pill. Page says the factors could be genetic, biological, or hormonal. Men churn out about 1,000 sperm per second (compared to one egg per month). A 100 percent effective pill would have to narrow it down to less than 1 million sperm per ml of semen.

Yet, there’s reason for hope. The male pill is actually not a pill, but rather a duo of drugs delivered via injections or patches: progestin, which knocks down the levels of intra-testicular testosterone and depletes sperm; and androgen, which replaces testosterone in other parts of the body so you can maintain muscle mass and erectile function.

In other words, says Diana Blithe, Ph.D., a contraception researcher at the National Institute of Child Health and Human Development, a male contraceptive may increase muscle mass, lower body fat, and improve sexual function in some men. These “side effects,” adds Blithe, could eventually spell big profits for Big Pharma.

4 Myths About Men and STDs

Think of 20 guys you know. Now, which two have herpes? Which one has syphilis? Which 10 carry human papillomavirus (HPV)? In other words . . . no, STDs haven’t gone away. In fact, cases of chlamydia and gonorrhea are rising again. “Because we don’t talk about STDs much anymore, men are letting their guard down,” says Terri Warren, founder of Westover Heights Clinic in Portland, Oregon. Improve your defenses by dispelling these myths.

Myth #1: You can contract genital herpes only if your partner is having an outbreak“The herpes virus can transfer even if there’s no lesion,” says Matt Golden, M.D., an associate professor of medicine and infectious diseases at the University of Washington. According to Warren, condoms protect only the area they cover, leaving openings for skin-to-skin transmission. A simple rule: The thinner the skin, the more likely you are to catch the infection. Leg-to-leg contact . . . highly unlikely. Pubic rubbing or open-mouth kissing . . . you’re putting yourself at risk. Antiviral medications such as Valtrex can reduce the rate of transmission by almost half.

Myth #2: HPV is her problem HPV is actually the most common sexually transmitted infection in women and men. In 90 percent of cases, the body’s immune system kills the virus within 2 years. But HPV can cause genital warts and, penile or anal cancer (penile cancer is pretty rare, only 1 in 100,000 men get it). A male HPV vaccine does not yet exist, says Warren, so see a doctor if you spot a suspicious growth down below.

Myth #3: STDs can spread via public toilet seats “There are no documented cases of transmission from toilet seats,” says Gary Rose, M.D., President and CEO of the Medical Institute for Sexual Health. Bugs need blood or other bodily fluids to survive longer than a few minutes—meaning it’s nearly impossible to catch an infection from an inanimate, cold surface.

Myth #4: A condom offers a high degree of protection Condoms aren’t foolproof, says Golden. In fact, with some STDs, condoms are not particularly effective at all. Roll one on and you’re only 80 to 95 percent less likely to contract HIV [and 60 percent less likely to contract HPV].

The Marlboro Man’s Dirty Little Secret

The ladies love the Marlboro Man. Too bad he can’t love them back.

In a 2005 study published in the journal International Journal of Impotence Research, researchers looked at 860 men—with a mean age of 32—and found that 39% of them were heavy smokers compared to only 4% of the general population. Another study compared risk factors for erectile dysfunction, and smoking had a higher correlation with impotence than diabetes. Smoking reeks havoc on the nerves and blood vessels required to get and keep an erection, the researchers say.

And don’t think you’re okay because you only smoke a few a day. “"Tobacco use is a leading cause of impotence and the more your smoke, the higher the risk of impotence," says Michael Fiore, M.D., director on the Center for Tobacco Research and Intervention at the University of Wisconsin at Madison. “But, quitting makes a difference—smoking cessation is associated with improved erections.”

Privates in Peril

The plastic your son plays with today could influence the wood he’ll wield tomorrow. Here’s why: Soft plastic toys and infant products are made using phthalates—compounds that researchers now believe may stunt the growth of developing penises. This prompted U.S. lawmakers to ban the chemicals from new products starting in January, 2009. However, that doesn’t eliminate all the toys and teething rings people will buy in the meantime. What’s more, animal studies suggest that if an expectant mom is exposed to phthalates, her baby’s privates can be undermined in utero.

There are yet other genital threats. First, Danish researchers recently discovered that boys born to women who worked in greenhouses while pregnant were more likely to have shorter-than-normal penises and had three times the risk of developing undescended testicles. There’s also controversial evidence that, despite a recent “all-clear” from the FDA, bisphenol A, a plastic hardener used in baby bottles, may cause hormone imbalances that could lead to missing inches down below. So what’s a paranoid parent to do? Eliminate these chemical culprits from your life.

Phthalates Consult healthytoys.org before shopping and thegreenguide.com/doc/int/phthalates before buying hygiene products. Some companies list phthalates on their product labels but are not required to do so by law. Your best bet: Buy fragrance-free products and double-check the ingredient list for phthalates. For plastic products, check the resin identification code. Avoid using plastics bearing codes 3, 6, and 7. Codes 1, 2, 4, and 5 do not contain phthalates.

PesticidesAvoid produce, meat, or dairy products that come from farms that use pesticides. Can’t find an organic market near you? Go to localharvest.org to pinpoint pesticide-free farmer’s markets, restaurants, and grocery stores.

Bisphenol A BPA is found in the plastic lining of almost every can in your supermarket, including infant formula, according to research by the Environmental Working Group. If she’s decided not to breastfeed the baby, consider using powdered formula. Also, kick the cans by eating fresh or frozen foods, and switch to glass baby bottles or BPA-free bottles made by Born Free, available at at newbornfree.com.

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